Provider Demographics
NPI:1396834545
Name:SHMERLER, DAVID L (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:L
Last Name:SHMERLER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30-17 35TH ST.
Mailing Address - Street 2:APT. 1
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-4701
Mailing Address - Country:US
Mailing Address - Phone:917-751-7335
Mailing Address - Fax:
Practice Address - Street 1:251 LAFAYETTE ST FL 3
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-4067
Practice Address - Country:US
Practice Address - Phone:212-570-1693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015280103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02515942Medicaid